title: Resting energy expenditure and the effects of muscle wasting in patients with chronic heart failure: results from the Studies Investigating Comorbidities Aggravating Heart Failure (SICA-HF).
abstract: OBJECTIVE
  Muscle wasting is common in patients with chronic heart failure (HF) and worsens functional status. Protein catabolism is characteristic of muscle wasting and contributes to resting energy expenditure (REE). Glucagonlike peptide 1 (GLP-1) is linked to REE in healthy individuals. We aimed to evaluate (1) whether REE is elevated in patients with HF with muscle wasting, and (2) whether basal GLP-1 levels are linked to REE in HF.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Ambulatory patients with HF were recruited at the Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
  
  
  METHODS
  A total of 166 patients with HF and 27 healthy controls participating in the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) were enrolled. GLP-1 was measured in 55 of these patients.
  
  
  METHODS
  Body composition was measured by dual-energy X-ray absorptiometry (DEXA). Muscle wasting was defined as appendicular lean mass of at least 2 SDs below values of a healthy young reference group. REE was measured by indirect calorimetry. GLP-1 was assessed by ELISA.
  
  
  RESULTS
  Thirty-four of 166 patients (mean age 67.4 ± 10.2 years, 77.7% male, New York Heart Association class 2.3 ± 0.6) presented with muscle wasting. REE in controls and patients with muscle wasting was significantly lower than in patients without muscle wasting (1579 ± 289 and 1532 ± 265 vs 1748 ± 359 kcal/d, P = .018 and P = .001, respectively). REE normalized for fat-free mass (FFM) using the ratio method (REE/FFM) and analysis of covariance was not different (P = .23 and .71, respectively). GLP-1 did not significantly correlate with REE (P = .49), even not after controlling for FFM using multivariable regression (P = .15).
  
  
  CONCLUSIONS
  Differences in REE are attributable to lower FFM. GLP-1 does not relate to REE in patients with HF, possibly because of HF-related effects on REE.
authors.affiliation: Applied Cachexia Research, Department of Cardiology, Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Tacke
authors.forename: Nicole
authors.initials: N
authors.lastname: Ebner
authors.forename: Michael
authors.initials: M
authors.lastname: Boschmann
authors.forename: Annett
authors.initials: A
authors.lastname: Jarius
authors.forename: Miroslava
authors.initials: M
authors.lastname: Valentova
authors.forename: Susann
authors.initials: S
authors.lastname: Fülster
authors.forename: Anja
authors.initials: A
authors.lastname: Sandek
authors.forename: Lutz
authors.initials: L
authors.lastname: Schomburg
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.forename: Wolfram
authors.initials: W
authors.lastname: Doehner
authors.forename: Stephan
authors.initials: S
authors.lastname: von Haehling
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D001823:Body Composition; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005260:Female; D005858:Germany; D052216:Glucagon-Like Peptide 1 / Q000032:analysis; D006333:Heart Failure / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012146:Rest; D055948:Sarcopenia / Q000503:physiopathology*
chemical_list: D052216:Glucagon-Like Peptide 1
keywords: Heart failure; glucagonlike peptide 1; muscle wasting; resting energy expenditure